09. Cholinergic and Anticholinergic Drugs Flashcards by Megan Hamilton

Cholinergics vs. Anti-cholinergics: HEART RATE

Cholinergics: Decreased HR, Vasodilitation

Anti-cholinergics: Increased HR

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Cholinergics vs. Anti-cholinergics: BRONCHUS

Cholinergics:
- Bronchoconstriction
- Increased secretions
- Increased salivation
Anti-cholinergics:
- Decreased secretions
- Decreased salvation

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Cholinergics vs. Anti-cholinergics: PUPILS

Cholinergics: Contriction

Anti-cholinergics: Dilation

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Cholinergics vs. Anti-cholinergics: GI

Cholinergics:
- Increased motility, increased secretions
Anti-cholinergics:
- Decreased motility, decreased secretions

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Cholinergics vs. Anti-cholinergics: SWEATING

Cholinergics: Increased sweating

Anti-cholinergics: Decreased sweating

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Cholinergics vs. Anti-cholinergics: UA

Cholinergics: Voiding (due to relaxation of sphincter)

Anti-cholinergics: Retention

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Cholinergics vs. Anti-cholinergics: CNS

Cholinergics: ~

Anti-cholinergics: Stimulation of CNS –> Depression in large doses

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Cholinergics (4) vs. Anti-cholinergics (5): USES

Cholinergics: Limited, but varied:

UA retention
Dx & Tx of MG
Alzheimer’s
Glaucoma

Anti-cholinergics:

Antipasmodics
Tx Parkinson’s
Asthma
Bradycardia
Pre-op: Decreased vagal stimulation

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Parasympathominetic refers to the ______ classification of drugs, which has the same effect as _______ the PSNS.

Cholinergic

Stimulating

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Cholinergic prototype

Neostigmine (Prostigmine)

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Parasympatholitic refers to the _______ classification of drugs, which has the same effect as _____ the PSNS.

Anti-cholinergic

Inhibiting

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Anti-cholinergic prototype

Atropine

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What effect does neostigmine have on nicotinic receptors?

In motor nerves and skeletal muscles –> Muscle contraction

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What effect does neostigmine have on muscarinic receptors?

In most internal organs –> Increased secretions

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Cholinergic v. Anti-cholinergic: SALIVARY GLAND

Cholinergic: Increased salivation

Anti-cholinergic:

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Neostigmine mimics the action of ______ AND inhibits ints destruction.

Acetylcholine

Name four drugs that mimic the action of Acetylcholine.

Neostigmine
Urecholine
Reglan
Pilocarpine

Six clinical uses of neostigmine.

Bladder atony. (Helps relax the sphincter and allow pt to urinate)
Dx & Tx of Myasthenia Gravis
Anedote (to depolarizing neurotransmitter blockers in the OR)
Glaucoma (causes miosis, which decreases pressure in the eye)
Alzheimer’s
GI tract atony

What is Myasthenia Gravis? What treats it?

Autoimmune neuromuscular disease. Neostigmine.

5 common side effects of Neostigmine

*Exacerbation of intended effects:
Salivation
Diaphoresis (sweating)
Abdominal camping
N/V
Diarrhea

3 serious ADEs of Neostigmine:

Bradycardia
Hypotension
Shock

What is a cholinergic crisis?

Too much anticholinesterace (cholinergic drug)

What is a Myasthenia crisis?

Dose to control Myasthenia Gravis is too small; pt needs larger dose.

How do you tell the difference between a cholinergic crisis and a Myasthenia crisis?
…in a crisis?

Order a dose of endrophonium (Tensilon)

- Just order an antidote - Atropine.

Atropine blocks the action of _______

Acetylcholine

Anti-cholinergic prototype

Atropine

Atropine ADEs - Common (5) - Serious (2)

COMMON - Blurred vision - Dry mouth - Constipation - Urinary retention - Photophobia SERIOUS - Cardiac arrhythmias - Tachyarrhythmias

6 Contraindications of Atropine

- Prostatic hypertrophy - Glaucoma - Tachy arrhythmias - Acute MI - Congestive Heart Failure - Myasthenia Gravis (although atropine is an anecdote if pt is over-treated for MG with Neostigmine)

In a Myasthenic crisis, ________ is an anecdote for too much _______.

Atropine, neostigmine.